Y74 Orchitis/epididymitis (ICD-10:N45.9)

Introduction

Orchitis/epididymitis is a condition characterized by inflammation of the testicles (orchitis) or the tube that carries sperm from the testicle (epididymitis). It can be caused by bacterial or viral infections, and it commonly affects younger men^[1]. This guide aims to provide a comprehensive overview of the symptoms, causes, diagnostic steps, possible interventions, and lifestyle interventions for orchitis/epididymitis.

Codes

• ICPC-2 Code: Y74 Orchitis/epididymitis
• ICD-10 Code: N45.9 Orchitis, epididymitis and epididymo-orchitis, without abscess

Symptoms

• Pain in the testicles or scrotum
• Swelling and redness in the affected area
• Tenderness or sensitivity in the testicles
• Warmth or fever
• Urinary symptoms such as frequent urination or pain during urination^[2]

Causes

• Bacterial infection: Most commonly caused by sexually transmitted infections such as chlamydia or gonorrhea. It can also be caused by urinary tract infections or prostate infections^[3].
• Viral infection: Orchitis/epididymitis can be a complication of viral infections such as mumps^[4].

Diagnostic Steps

Medical History

• Gather information about the patient’s symptoms, including the duration and severity of pain, any urinary symptoms, and recent sexual activity.
• Ask about any history of recent infections or exposure to sexually transmitted infections.
• Assess the patient’s medical history, including any previous episodes of orchitis/epididymitis or other urological conditions^[5].

Physical Examination

• Perform a thorough physical examination of the scrotum and testicles to assess for swelling, tenderness, or redness.
• Palpate the epididymis for any abnormalities or signs of inflammation.
• Check for the presence of a mass or lump in the scrotum^[6].

Laboratory Tests

• Urine analysis: A urine sample can be tested for the presence of bacteria or white blood cells, which may indicate an infection.
• Blood tests: Blood tests can help assess the presence of infection and rule out other conditions such as testicular torsion.
• Sexually transmitted infection testing: Depending on the patient’s sexual history, testing for common sexually transmitted infections such as chlamydia and gonorrhea may be necessary^[7].

Diagnostic Imaging

• Ultrasound: An ultrasound of the scrotum can help visualize the testicles and epididymis, and identify any signs of inflammation or torsion^[8].
• CT scan or MRI: In some cases, a CT scan or MRI may be ordered to assess the extent of the infection or rule out other conditions^[9].

Other Tests

• Urological referral: If the cause of orchitis/epididymitis is unclear or if there are concerns about underlying urological conditions, a referral to a urologist may be necessary.
• Testicular biopsy: In rare cases, a biopsy of the testicle may be performed to rule out testicular cancer^[10].

Follow-up and Patient Education

• Schedule a follow-up appointment to assess the patient’s response to treatment and ensure resolution of symptoms.
• Educate the patient about the importance of completing the full course of antibiotics if bacterial infection is the cause.
• Advise the patient about the importance of safe sexual practices to prevent future episodes of orchitis/epididymitis.

Possible Interventions

Traditional Interventions

Medications:

Top 5 drugs for Orchitis/epididymitis:

1. Antibiotics (e.g., Ciprofloxacin, Doxycycline):
   • Cost: Generic versions can be $10-$50 for a full course of treatment.
   • Contraindications: Hypersensitivity to antibiotics, pregnancy, and breastfeeding.
   • Side effects: Nausea, diarrhea, and allergic reactions.
   • Severe side effects: Tendon rupture, liver toxicity.
   • Drug interactions: Antacids, other antibiotics that can interfere with absorption.
   • Warning: Finish the full course of antibiotics as prescribed.
2. Nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., Ibuprofen, Naproxen):
   • Cost: Generic versions can be $5-$20 for a supply.
   • Contraindications: Active peptic ulcers, kidney disease, and bleeding disorders.
   • Side effects: Upset stomach, increased risk of bleeding, and kidney problems.
   • Severe side effects: Severe allergic reactions, gastrointestinal bleeding.
   • Drug interactions: Other NSAIDs, blood thinners.
   • Warning: Take with food to minimize stomach upset.
3. Analgesics (e.g., Acetaminophen):
   • Cost: Generic versions can be $3-$10 for a supply.
   • Contraindications: Liver disease, alcoholism, and hypersensitivity to acetaminophen.
   • Side effects: Rare at recommended doses, but can cause liver damage in high doses.
   • Severe side effects: Severe allergic reactions and liver failure.
   • Drug interactions: Alcohol, other medications containing acetaminophen.
   • Warning: Do not exceed the recommended dose.
4. Antivirals (e.g., Valacyclovir):
   • Cost: Generic versions can be $20-$100 for a full course of treatment.
   • Contraindications: Hypersensitivity to antivirals.
   • Side effects: Nausea, headache, and dizziness.
   • Severe side effects: Seizures, hallucinations, and severe allergic reactions.
   • Drug interactions: Probenecid, other antivirals.
   • Warning: Take as prescribed and complete the full course of treatment.
5. Steroids (e.g., Prednisone):
   • Cost: Generic versions can be $5-$20 for a supply.
   • Contraindications: Active infections, uncontrolled diabetes, and glaucoma.
   • Side effects: Increased appetite, weight gain, and mood changes.
   • Severe side effects: Increased risk of infections, osteoporosis, and adrenal insufficiency.
   • Drug interactions: Nonsteroidal anti-inflammatory drugs, anticoagulants.
   • Warning: Taper the dose gradually when discontinuing.

Alternative Drugs:

• Herbal supplements: Some herbal supplements such as saw palmetto or turmeric may have anti-inflammatory properties. Cost: Varies depending on the specific supplement.
• Homeopathic remedies: Homeopathic remedies such as pulsatilla or cantharis are believed to help reduce inflammation and pain. Cost: Varies depending on the specific remedy.

Surgical Procedures:

In most cases, surgical intervention is not necessary for the treatment of orchitis/epididymitis. However, if complications such as an abscess or testicular infarction develop, surgical drainage or removal of the affected tissue may be required. The cost of surgical procedures can vary significantly depending on the specific case and location.

Alternative Interventions

• Acupuncture: May help reduce inflammation and alleviate pain. Cost: $60-$120 per session.
• Heat therapy: Applying a warm compress to the affected area can help relieve pain and promote healing. Cost: Minimal.
• Physical therapy: Stretching and strengthening exercises can help improve blood flow and reduce pain. Cost: Varies depending on the specific therapy.
• Relaxation techniques: Stress reduction techniques such as meditation or deep breathing exercises can help manage pain and promote healing. Cost: Minimal.
• Alternative medicine: Some alternative therapies such as Ayurveda or Traditional Chinese Medicine may offer additional options for managing orchitis/epididymitis. Cost: Varies depending on the specific therapy.

Lifestyle Interventions

• Rest and elevation: Resting and elevating the scrotum can help reduce swelling and promote healing. Cost: Minimal.
• Avoidance of irritants: Avoiding activities or substances that may irritate the scrotum, such as tight underwear or harsh soaps, can help prevent further inflammation. Cost: Minimal.
• Hydration: Staying well-hydrated can help flush out bacteria and promote healing. Cost: Minimal.
• Healthy diet: Eating a balanced diet rich in fruits, vegetables, and lean proteins can support the immune system and promote healing. Cost: Varies depending on food choices.
• Safe sexual practices: Practicing safe sex and using barrier methods such as condoms can help prevent sexually transmitted infections and reduce the risk of orchitis/epididymitis. Cost: Minimal.

It is important to note that the cost ranges provided are approximate and may vary depending on the location and availability of the interventions. It is always recommended to consult with a healthcare professional for personalized treatment options and cost estimates.

Mirari Cold Plasma Alternative Intervention

Understanding Mirari Cold Plasma

• Safe and Non-Invasive Treatment: Mirari Cold Plasma is a safe and non-invasive treatment option for various skin conditions. It does not require incisions, minimizing the risk of scarring, bleeding, or tissue damage.
• Efficient Extraction of Foreign Bodies: Mirari Cold Plasma facilitates the removal of foreign bodies from the skin by degrading and dissociating organic matter, allowing easier access and extraction.
• Pain Reduction and Comfort: Mirari Cold Plasma has a local analgesic effect, providing pain relief during the treatment, making it more comfortable for the patient.
• Reduced Risk of Infection: Mirari Cold Plasma has antimicrobial properties, effectively killing bacteria and reducing the risk of infection.
• Accelerated Healing and Minimal Scarring: Mirari Cold Plasma stimulates wound healing and tissue regeneration, reducing healing time and minimizing the formation of scars.

Mirari Cold Plasma Prescription

Video instructions for using Mirari Cold Plasma Device – Y74 Orchitis/epididymitis (ICD-10:N45.9)

Localized (0) Sacrum (1) Prostate & Uterus (2) Kidney, Liver & Spleen (3) Heart, Bile & Pancreas (4) Lungs (5) Throat, Lymphatic & Thyroid (6) Neuro system & ENT (7)

Use the Mirari Cold Plasma device to treat Orchitis/epididymitis effectively.

WARNING: MIRARI COLD PLASMA IS DESIGNED FOR THE HUMAN BODY WITHOUT ANY ARTIFICIAL OR THIRD PARTY PRODUCTS. USE OF OTHER PRODUCTS IN COMBINATION WITH MIRARI COLD PLASMA MAY CAUSE UNPREDICTABLE EFFECTS, HARM OR INJURY. PLEASE CONSULT A MEDICAL PROFESSIONAL BEFORE COMBINING ANY OTHER PRODUCTS WITH USE OF MIRARI.

Step 1: Cleanse the Skin

• Start by cleaning the affected area of the skin with a gentle cleanser or mild soap and water. Gently pat the area dry with a clean towel.

Step 2: Prepare the Mirari Cold Plasma device

• Ensure that the Mirari Cold Plasma device is fully charged or has fresh batteries as per the manufacturer’s instructions. Make sure the device is clean and in good working condition.
• Switch on the Mirari device using the power button or by following the specific instructions provided with the device.
• Some Mirari devices may have adjustable settings for intensity or treatment duration. Follow the manufacturer’s instructions to select the appropriate settings based on your needs and the recommended guidelines.

Step 3: Apply the Device

• Place the Mirari device in direct contact with the affected area of the skin. Gently glide or hold the device over the skin surface, ensuring even coverage of the area experiencing.
• Slowly move the Mirari device in a circular motion or follow a specific pattern as indicated in the user manual. This helps ensure thorough treatment coverage.

Step 4: Monitor and Assess:

• Keep track of your progress and evaluate the effectiveness of the Mirari device in managing your Orchitis/epididymitis. If you have any concerns or notice any adverse reactions, consult with your health care professional.

Note

This guide is for informational purposes only and should not replace the advice of a medical professional. Always consult with your healthcare provider or a qualified medical professional for personal advice, diagnosis, or treatment. Do not solely rely on the information presented here for decisions about your health. Use of this information is at your own risk. The authors of this guide, nor any associated entities or platforms, are not responsible for any potential adverse effects or outcomes based on the content.

Mirari Cold Plasma System Disclaimer

• Purpose: The Mirari Cold Plasma System is a Class 2 medical device designed for use by trained healthcare professionals. It is registered for use in Thailand and Vietnam. It is not intended for use outside of these locations.
• Informational Use: The content and information provided with the device are for educational and informational purposes only. They are not a substitute for professional medical advice or care.
• Variable Outcomes: While the device is approved for specific uses, individual outcomes can differ. We do not assert or guarantee specific medical outcomes.
• Consultation: Prior to utilizing the device or making decisions based on its content, it is essential to consult with a Certified Mirari Tele-Therapist and your medical healthcare provider regarding specific protocols.
• Liability: By using this device, users are acknowledging and accepting all potential risks. Neither the manufacturer nor the distributor will be held accountable for any adverse reactions, injuries, or damages stemming from its use.
• Geographical Availability: This device has received approval for designated purposes by the Thai and Vietnam FDA. As of now, outside of Thailand and Vietnam, the Mirari Cold Plasma System is not available for purchase or use.

References

1. Centers for Disease Control and Prevention. (2021). Epididymitis. Retrieved from https://www.cdc.gov/std/treatment-guidelines/epididymitis.htm
2. Mayo Clinic. (2022). Orchitis – Symptoms and causes. Retrieved from https://www.mayoclinic.org/diseases-conditions/orchitis/symptoms-causes/syc-20375860
3. Trojian, T. H., Lishnak, T. S., & Heiman, D. (2009). Epididymitis and orchitis: an overview. American Family Physician, 79(7), 583-587.
4. World Health Organization. (2022). Mumps. Retrieved from https://www.who.int/news-room/fact-sheets/detail/mumps
5. Workowski, K. A., & Bolan, G. A. (2015). Sexually transmitted diseases treatment guidelines, 2015. MMWR Recommendations and Reports, 64(RR-03), 1-137.
6. Coker, T. J., & Dierfeldt, D. M. (2016). Acute bacterial prostatitis: diagnosis and management. American Family Physician, 93(2), 114-120.
7. Papp, J. R., Schachter, J., Gaydos, C. A., & Van Der Pol, B. (2014). Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae – 2014. MMWR Recommendations and Reports, 63(RR-02), 1-19.
8. Dogra, V. S., Gottlieb, R. H., Oka, M., & Rubens, D. J. (2003). Sonography of the scrotum. Radiology, 227(1), 18-36.
9. Nickel, J. C., Shoskes, D. A., & Wagenlehner, F. M. (2013). Management of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS): diagnosis and treatment options. European Urology Supplements, 12(5), 88-96.
10. Wein, A. J., Kavoussi, L. R., Partin, A. W., & Peters, C. A. (2016). Campbell-Walsh Urology (11th ed.). Philadelphia, PA: Elsevier.